Heading causes dementia?

Research uncovers link, football authorities 'in denial'


Football 'in denial' over dementia heading risk

Football authorities are "in denial" over the link between heading a ball and serious brain injury, according to the family of Chesterfield FC's all-time leading goalscorer.

Ernie Moss, 67, is still held in the highest esteem by fans of the Derbyshire club, but over recent years he has succumbed to the onset of dementia, which has now severely limited his speech and ability to interact.

He only ever leaves his home to go to watch Chesterfield play and needs round-the-clock care from his family.

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Mixed pathologies including chronic traumatic encephalopathy account for dementia in retired association football players

The research

Chronic traumatic encephalopathy (CTE) is a potential neurodegenerative cause of dementia and motor impairments in retired professional association football (soccer) players with a past history of repetitive head impacts,

From 1980 to 2010, 14 retired footballers with dementia were followed up regularly until death. Their clinical data, playing career, and concussion history were prospectively collected. Next-of-kin provided consent for six to have post-mortem brain examination.

Of the 14 male participants, 13 were professional and 1 was a committed amateur. All were skilled headers of the ball and had played football for an average of 26 years. Concussion rate was limited in six cases to one episode each during their careers.

All cases developed progressive cognitive impairment with an average age at onset of 63.6 years and disease duration of 10 years. Neuropathological examination revealed septal abnormalities in all six post-mortem cases, supportive of a history of chronic repetitive head impacts.

Four cases had pathologically confirmed CTE; concomitant pathologies included Alzheimer’s disease (N = 6), TDP-43 (N = 6), cerebral amyloid angiopathy (N = 5), hippocampal sclerosis (N = 2), corticobasal degeneration (N = 1), dementia with Lewy bodies (N = 1), and vascular pathology (N = 1); and all would have contributed synergistically to the clinical manifestations.

The pathological diagnosis of CTE was established in four individuals according to the latest consensus diagnostic criteria. This finding is probably related to their past prolonged exposure to repetitive head impacts from head-to-player collisions and heading the ball thousands of time throughout their careers.

Alzheimer’s disease and TDP-43 pathologies are common concomitant findings in CTE, both of which are increasingly considered as part of the CTE pathological entity in older individuals.

Association football is the most popular sport in the world and the potential link between repetitive head impacts from playing football and CTE as indicated from our findings is of considerable public health interest.

Clearly, a definitive link cannot be established in this clinico-pathological series, but our findings support the need for further systematic investigation, including large-scale case–control studies to identify at risk groups of footballers which will justify the implementation of protective strategies.

Ling, H., Morris, H.R., Neal, J.W. et al. Acta Neuropathol (2017). doi:10.1007/s00401-017-1680-3

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The Scotsman

Possible link found between dementia and heading footballs

A potential cause of dementia thought to arise from blows to the head has, for the first time, been confirmed in a group of retired footballers.

The findings, from a study of 14 former players, suggest a possible link between playing football and developing such conditions later in life, researchers said.

The results provide a platform for a "pressing research question" on whether dementia is more common in footballers than the general population, Dr Helen Ling, lead author of the UCL Queen Square Brain Bank study said.

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